|
HC NM MYCRD IMG PET RST/STRS W/CT
|
Facility
|
IP
|
$3,046.00
|
|
|
Service Code
|
CPT 78430
|
| Hospital Charge Code |
909308430
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.33 |
| Max. Negotiated Rate |
$2,284.50 |
| Rate for Payer: Adventist Health Commercial |
$609.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,961.62
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,062.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,062.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$551.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$761.50
|
| Rate for Payer: Multiplan Commercial |
$2,284.50
|
|
|
HC NM MYCRD IMG PET RST/STRS W/CT
|
Facility
|
OP
|
$3,046.00
|
|
|
Service Code
|
CPT 78430
|
| Hospital Charge Code |
909308430
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.33 |
| Max. Negotiated Rate |
$2,758.72 |
| Rate for Payer: Adventist Health Commercial |
$609.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,882.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,758.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,023.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,839.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,523.61
|
| Rate for Payer: Blue Shield of California Commercial |
$1,858.06
|
| Rate for Payer: Blue Shield of California EPN |
$1,486.45
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,979.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,758.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,023.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,839.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,979.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,839.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,885.47
|
| Rate for Payer: Heritage Provider Network Senior |
$1,885.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,839.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,452.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$551.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,115.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$761.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,464.46
|
| Rate for Payer: Multiplan Commercial |
$2,284.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,023.07
|
| Rate for Payer: TriValley Medical Group Senior |
$1,839.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,523.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,523.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,758.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,023.07
|
| Rate for Payer: Vantage Medical Group Senior |
$1,839.15
|
|
|
HC NM MYOCRD IMG PET 1 STUDY W/CT
|
Facility
|
IP
|
$3,046.00
|
|
|
Service Code
|
CPT 78429
|
| Hospital Charge Code |
909308429
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.33 |
| Max. Negotiated Rate |
$2,284.50 |
| Rate for Payer: Adventist Health Commercial |
$609.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,961.62
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,062.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,062.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$551.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$761.50
|
| Rate for Payer: Multiplan Commercial |
$2,284.50
|
|
|
HC NM MYOCRD IMG PET 1 STUDY W/CT
|
Facility
|
OP
|
$3,046.00
|
|
|
Service Code
|
CPT 78429
|
| Hospital Charge Code |
909308429
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.33 |
| Max. Negotiated Rate |
$2,758.72 |
| Rate for Payer: Adventist Health Commercial |
$609.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,882.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,758.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,023.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,839.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,523.61
|
| Rate for Payer: Blue Shield of California Commercial |
$1,858.06
|
| Rate for Payer: Blue Shield of California EPN |
$1,486.45
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,979.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,758.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,023.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,839.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,979.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,839.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,885.47
|
| Rate for Payer: Heritage Provider Network Senior |
$1,885.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,839.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,452.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$551.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,115.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$761.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,464.46
|
| Rate for Payer: Multiplan Commercial |
$2,284.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,023.07
|
| Rate for Payer: TriValley Medical Group Senior |
$1,839.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,523.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,523.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,758.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,023.07
|
| Rate for Payer: Vantage Medical Group Senior |
$1,839.15
|
|
|
HC NM MYOCRD IMG PET DUAL TRCR CT
|
Facility
|
OP
|
$5,807.00
|
|
|
Service Code
|
CPT 78433
|
| Hospital Charge Code |
909308433
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,051.07 |
| Max. Negotiated Rate |
$4,355.25 |
| Rate for Payer: Adventist Health Commercial |
$1,161.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,588.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4,249.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,116.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,833.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,904.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3,542.27
|
| Rate for Payer: Blue Shield of California EPN |
$2,833.82
|
| Rate for Payer: Cash Price |
$2,613.15
|
| Rate for Payer: Cash Price |
$2,613.15
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3,774.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,249.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$3,116.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,833.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,774.55
|
| Rate for Payer: EPIC Health Plan Medicare |
$2,833.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,594.53
|
| Rate for Payer: Heritage Provider Network Senior |
$3,594.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,833.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,769.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,051.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,258.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,451.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,796.42
|
| Rate for Payer: Multiplan Commercial |
$4,355.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$3,116.47
|
| Rate for Payer: TriValley Medical Group Senior |
$2,833.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2,903.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2,903.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,249.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,116.47
|
| Rate for Payer: Vantage Medical Group Senior |
$2,833.15
|
|
|
HC NM MYOCRD IMG PET DUAL TRCR CT
|
Facility
|
IP
|
$5,807.00
|
|
|
Service Code
|
CPT 78433
|
| Hospital Charge Code |
909308433
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$1,051.07 |
| Max. Negotiated Rate |
$4,355.25 |
| Rate for Payer: Adventist Health Commercial |
$1,161.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,739.71
|
| Rate for Payer: Cash Price |
$2,613.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,931.34
|
| Rate for Payer: Heritage Provider Network Senior |
$3,931.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,051.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,451.75
|
| Rate for Payer: Multiplan Commercial |
$4,355.25
|
|
|
HC NM RP LCLZTN TMR SPECT W/CT 1
|
Facility
|
OP
|
$2,686.00
|
|
|
Service Code
|
CPT 78830
|
| Hospital Charge Code |
909308830
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$486.17 |
| Max. Negotiated Rate |
$2,497.70 |
| Rate for Payer: Adventist Health Commercial |
$537.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,659.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,665.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,343.54
|
| Rate for Payer: Blue Shield of California Commercial |
$2,427.07
|
| Rate for Payer: Blue Shield of California EPN |
$1,951.77
|
| Rate for Payer: Cash Price |
$1,208.70
|
| Rate for Payer: Cash Price |
$1,208.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,745.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,831.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,665.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,745.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,665.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,662.63
|
| Rate for Payer: Heritage Provider Network Senior |
$1,662.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,665.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,281.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$486.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,914.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$671.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,231.27
|
| Rate for Payer: Multiplan Commercial |
$2,014.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$1,831.64
|
| Rate for Payer: TriValley Medical Group Senior |
$1,665.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,343.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,343.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,497.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,831.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1,665.13
|
|
|
HC NM RP LCLZTN TMR SPECT W/CT 1
|
Facility
|
IP
|
$2,686.00
|
|
|
Service Code
|
CPT 78830
|
| Hospital Charge Code |
909308830
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$486.17 |
| Max. Negotiated Rate |
$2,014.50 |
| Rate for Payer: Adventist Health Commercial |
$537.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,729.78
|
| Rate for Payer: Cash Price |
$1,208.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,818.42
|
| Rate for Payer: Heritage Provider Network Senior |
$1,818.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$486.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$671.50
|
| Rate for Payer: Multiplan Commercial |
$2,014.50
|
|
|
HC NM RP LCLZTN TMR SPECT W/CT 2
|
Facility
|
OP
|
$3,046.00
|
|
|
Service Code
|
CPT 78832
|
| Hospital Charge Code |
909308832
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.33 |
| Max. Negotiated Rate |
$4,757.81 |
| Rate for Payer: Adventist Health Commercial |
$609.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,882.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,758.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,023.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,839.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,523.61
|
| Rate for Payer: Blue Shield of California Commercial |
$4,757.81
|
| Rate for Payer: Blue Shield of California EPN |
$3,826.07
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1,979.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,758.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,023.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,839.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,979.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,839.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,885.47
|
| Rate for Payer: Heritage Provider Network Senior |
$1,885.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,839.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,452.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$551.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,115.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$761.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2,464.46
|
| Rate for Payer: Multiplan Commercial |
$2,284.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,023.07
|
| Rate for Payer: TriValley Medical Group Senior |
$1,839.15
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,523.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,523.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,758.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,023.07
|
| Rate for Payer: Vantage Medical Group Senior |
$1,839.15
|
|
|
HC NM RP LCLZTN TMR SPECT W/CT 2
|
Facility
|
IP
|
$3,046.00
|
|
|
Service Code
|
CPT 78832
|
| Hospital Charge Code |
909308832
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$551.33 |
| Max. Negotiated Rate |
$2,284.50 |
| Rate for Payer: Adventist Health Commercial |
$609.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,961.62
|
| Rate for Payer: Cash Price |
$1,370.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,062.14
|
| Rate for Payer: Heritage Provider Network Senior |
$2,062.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$551.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$761.50
|
| Rate for Payer: Multiplan Commercial |
$2,284.50
|
|
|
HC NON-GYN FLUID WASH BRUSH PG
|
Facility
|
OP
|
$88.00
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
903800214
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.93 |
| Max. Negotiated Rate |
$103.87 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$54.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$60.21
|
| Rate for Payer: Blue Shield of California Commercial |
$103.87
|
| Rate for Payer: Blue Shield of California EPN |
$83.53
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$57.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$52.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$57.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$48.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$54.47
|
| Rate for Payer: Heritage Provider Network Senior |
$54.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$48.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$41.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$55.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$64.37
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$48.04
|
| Rate for Payer: TriValley Medical Group Senior |
$48.04
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$37.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$52.84
|
| Rate for Payer: Vantage Medical Group Senior |
$48.04
|
|
|
HC NON-GYN FLUID WASH BRUSH PG
|
Facility
|
IP
|
$88.00
|
|
|
Service Code
|
CPT 88104
|
| Hospital Charge Code |
903800214
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.93 |
| Max. Negotiated Rate |
$66.00 |
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$56.67
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$59.58
|
| Rate for Payer: Heritage Provider Network Senior |
$59.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.00
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
|
|
HC NON-GYN THIN-PREP, PG
|
Facility
|
IP
|
$232.00
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
903800213
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$174.00 |
| Rate for Payer: Adventist Health Commercial |
$46.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$149.41
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$157.06
|
| Rate for Payer: Heritage Provider Network Senior |
$157.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.00
|
| Rate for Payer: Multiplan Commercial |
$174.00
|
|
|
HC NON-GYN THIN-PREP, PG
|
Facility
|
OP
|
$232.00
|
|
|
Service Code
|
CPT 88112
|
| Hospital Charge Code |
903800213
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$41.99 |
| Max. Negotiated Rate |
$419.78 |
| Rate for Payer: Adventist Health Commercial |
$46.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$143.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$419.78
|
| Rate for Payer: Blue Shield of California Commercial |
$299.81
|
| Rate for Payer: Blue Shield of California EPN |
$241.10
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cash Price |
$104.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$150.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$73.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$150.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$67.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$143.61
|
| Rate for Payer: Heritage Provider Network Senior |
$143.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$67.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$110.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$89.81
|
| Rate for Payer: Multiplan Commercial |
$174.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$67.02
|
| Rate for Payer: TriValley Medical Group Senior |
$67.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$54.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$54.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$73.72
|
| Rate for Payer: Vantage Medical Group Senior |
$67.02
|
|
|
HC NONINVAS EST CRNRY FFR SW ANLYS CTA
|
Facility
|
OP
|
$2,317.00
|
|
|
Service Code
|
CPT 75580
|
| Hospital Charge Code |
909201580
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$225.00 |
| Max. Negotiated Rate |
$5,264.50 |
| Rate for Payer: Adventist Health Commercial |
$463.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,431.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,214.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,104.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,158.96
|
| Rate for Payer: Blue Shield of California Commercial |
$5,264.50
|
| Rate for Payer: Blue Shield of California EPN |
$4,233.53
|
| Rate for Payer: Cash Price |
$1,042.65
|
| Rate for Payer: Cash Price |
$1,042.65
|
| Rate for Payer: Cash Price |
$1,042.65
|
| Rate for Payer: Cash Price |
$1,042.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$910.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,214.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,104.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$874.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$1,104.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$573.00
|
| Rate for Payer: Heritage Provider Network Senior |
$521.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,104.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$1,105.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$419.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,270.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,480.00
|
| Rate for Payer: Multiplan Commercial |
$1,737.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$225.00
|
| Rate for Payer: TriValley Medical Group Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,158.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,158.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,656.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,214.93
|
| Rate for Payer: Vantage Medical Group Senior |
$1,104.48
|
|
|
HC NONINVAS EST CRNRY FFR SW ANLYS CTA
|
Facility
|
IP
|
$2,317.00
|
|
|
Service Code
|
CPT 75580
|
| Hospital Charge Code |
909201580
|
|
Hospital Revenue Code
|
350
|
| Min. Negotiated Rate |
$419.38 |
| Max. Negotiated Rate |
$1,737.75 |
| Rate for Payer: Adventist Health Commercial |
$463.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1,492.15
|
| Rate for Payer: Cash Price |
$1,042.65
|
| Rate for Payer: Cash Price |
$1,042.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$711.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$1,568.61
|
| Rate for Payer: Heritage Provider Network Senior |
$1,568.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$419.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$579.25
|
| Rate for Payer: Multiplan Commercial |
$1,737.75
|
|
|
HC NON INVS DET HRT FAIL AUG ECHO
|
Facility
|
IP
|
$819.00
|
|
|
Service Code
|
CPT 0932T
|
| Hospital Charge Code |
906811516
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$148.24 |
| Max. Negotiated Rate |
$5,478.00 |
| Rate for Payer: Adventist Health Commercial |
$163.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$527.44
|
| Rate for Payer: Cash Price |
$368.55
|
| Rate for Payer: Cash Price |
$368.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$5,478.00
|
| Rate for Payer: Heritage Provider Network Senior |
$4,982.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$148.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.75
|
| Rate for Payer: Multiplan Commercial |
$614.25
|
|
|
HC NON INVS DET HRT FAIL AUG ECHO
|
Facility
|
OP
|
$819.00
|
|
|
Service Code
|
CPT 0932T
|
| Hospital Charge Code |
906811516
|
|
Hospital Revenue Code
|
480
|
| Min. Negotiated Rate |
$148.24 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$163.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$506.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$592.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$434.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$395.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$409.66
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$368.55
|
| Rate for Payer: Cash Price |
$368.55
|
| Rate for Payer: Cash Price |
$368.55
|
| Rate for Payer: Cash Price |
$368.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$532.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$592.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$434.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$395.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$395.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$506.96
|
| Rate for Payer: Heritage Provider Network Senior |
$485.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$395.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$750.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$148.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$454.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$204.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$529.34
|
| Rate for Payer: Multiplan Commercial |
$614.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$434.53
|
| Rate for Payer: TriValley Medical Group Senior |
$395.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$575.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$483.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$592.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$434.53
|
| Rate for Payer: Vantage Medical Group Senior |
$395.03
|
|
|
HC NON SELECT INJ IMAG VENOUS STC
|
Facility
|
OP
|
$643.00
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
909020165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.38 |
| Max. Negotiated Rate |
$9,616.00 |
| Rate for Payer: Adventist Health Commercial |
$128.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$397.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$546.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$353.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$482.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$321.63
|
| Rate for Payer: Blue Shield of California Commercial |
$8,962.13
|
| Rate for Payer: Blue Shield of California EPN |
$7,178.49
|
| Rate for Payer: Cash Price |
$289.35
|
| Rate for Payer: Cash Price |
$289.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$417.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$546.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$546.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$546.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,616.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$398.02
|
| Rate for Payer: Heritage Provider Network Senior |
$398.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$306.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$116.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$450.10
|
| Rate for Payer: Multiplan Commercial |
$482.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,093.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$918.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$546.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$546.55
|
| Rate for Payer: Vantage Medical Group Senior |
$546.55
|
|
|
HC NON SELECT INJ IMAG VENOUS STC
|
Facility
|
IP
|
$643.00
|
|
|
Service Code
|
CPT 36299
|
| Hospital Charge Code |
909020165
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.38 |
| Max. Negotiated Rate |
$482.25 |
| Rate for Payer: Adventist Health Commercial |
$128.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$414.09
|
| Rate for Payer: Cash Price |
$289.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$435.31
|
| Rate for Payer: Heritage Provider Network Senior |
$435.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$116.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.75
|
| Rate for Payer: Multiplan Commercial |
$482.25
|
|
|
HC NON-SELECTIVE WOUND DEBRIDE
|
Facility
|
IP
|
$1,245.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
903200205
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$225.34 |
| Max. Negotiated Rate |
$933.75 |
| Rate for Payer: Adventist Health Commercial |
$249.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$801.78
|
| Rate for Payer: Cash Price |
$560.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$842.87
|
| Rate for Payer: Heritage Provider Network Senior |
$842.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$225.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.25
|
| Rate for Payer: Multiplan Commercial |
$933.75
|
|
|
HC NON-SELECTIVE WOUND DEBRIDE
|
Facility
|
OP
|
$1,245.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
903200205
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$933.75 |
| Rate for Payer: Adventist Health Commercial |
$510.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$769.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$560.25
|
| Rate for Payer: Cash Price |
$560.25
|
| Rate for Payer: Cash Price |
$560.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$809.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$809.25
|
| Rate for Payer: EPIC Health Plan Medicare |
$258.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$770.65
|
| Rate for Payer: Heritage Provider Network Senior |
$770.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$593.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$225.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$296.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$311.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$933.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC NON-SELECTIVE WOUND DEBRIDE MCAL
|
Facility
|
IP
|
$900.00
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
900407703
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$162.90 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Adventist Health Commercial |
$180.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$579.60
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$609.30
|
| Rate for Payer: Heritage Provider Network Senior |
$609.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$162.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.00
|
| Rate for Payer: Multiplan Commercial |
$675.00
|
|
|
HC NON-SELECTIVE WOUND DEBRIDE MCAL
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
900407703
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Adventist Health Commercial |
$369.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$556.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$585.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$585.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$258.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$557.10
|
| Rate for Payer: Heritage Provider Network Senior |
$557.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$429.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$162.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$296.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$675.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC NON-SELECTIVE WOUND DEBRIDE MCAL
|
Facility
|
OP
|
$900.00
|
|
|
Service Code
|
CPT 97602
|
| Hospital Charge Code |
901300074
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$100.00 |
| Max. Negotiated Rate |
$675.00 |
| Rate for Payer: Adventist Health Commercial |
$369.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$556.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$347.00
|
| Rate for Payer: Blue Shield of California Commercial |
$354.00
|
| Rate for Payer: Blue Shield of California EPN |
$284.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cash Price |
$405.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$585.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$585.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$258.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$557.10
|
| Rate for Payer: Heritage Provider Network Senior |
$557.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$429.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$162.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$296.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$675.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$100.00
|
| Rate for Payer: TriValley Medical Group Senior |
$100.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$261.00
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$220.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
